Clinical advance in difficult pediatric airway management

Abstract

Background Management of a pediatric airway can be a challenge for anesthesiologists, especially for anesthesiologists who did not get special pediatric anesthesia training. Up to now, there are new devices designed specifically for use in pediatric airway management. Also, several algorithms and guidelines specific to the pediatric difficult airway management have been suggested. Objective The aim of this article is to describe clinical advances in difficult pediatric airway management, and give key evaluation on the roles of new devices and techniques in the pediatric airway management. Content This article mainly describes challenges of pediatric airway management, management of anticipated and unanticipated difficult pediatric airways, available devices for managing the pediatric airway and extubation of pediatric patients with a difficult airway. Especially, it is emphasized that the management of both the anticipated and unanticipated difficult pediatric airway requires a forethought plan to reduce the risk of complications and to enhance patient safety. Moreover, the controversies of extra-glottic airway devices(EGAD) and alternative devices to direct laryngoscopy in pediatric airway management are elucidated. Trend Although airway management strategies for children, techniques and equipment are significantly improved during the past few years, management of difficult pediatric airway remains a problem associated with significant risks and complications. In the future, more efforts and multicentre studies are still needed to determine the best practices for managing the difficult pediatric airway Key words: Children; Airway management; Tracheal intubation